Wednesday, January 20, 2010

Thought of the Day

Sydney M. Williams

Thought of the Day

The victory of Scott Brown, in Tuesday’s Massachusetts Senatorial election, spells the defeat of the Democrat’s plan to overhaul healthcare in the United States, but it should not diminish the need to reform our healthcare system.

First,Tort reform is badly needed. Excessive payments in malpractice suits have had the twin effects of increasing the practice of defensive medicine, while raising the cost medical malpractice insurance. It is important that victims of medical malpractice practice be protected and that compensation be made when due. But frivolous lawsuits have served to enrich a host of trial lawyers, while doing little to curb mistakes, and have made the practice of medicine, in certain states which encourage such suits, prohibitively expensive. Patients, consequently, have suffered. The result fewer doctors, unnecessary tests and beleaguered patients.

Second, insurance companies should be permitted to compete across state lines. The easiest and most effective way to lower the cost of insurance is to increase the number of companies competing for the business.

Third, we need to find a way in which the consumer assumes more responsibility for the cost of services he requires. Employer-based plans, which have been in effect since the waning days of World War II, are part of the problem. They came into being during a time of wage controls and benefit plans were one way businesses could differentiate among themselves. That is no longer the case. As individuals, we purchase home and auto insurance. Each policy is essentially tailor-made to fit our specific needs. We decide the level of insurance we need and the degree of deductibility with which we are comfortable. Not so in health insurance where, under employer-based plans, one size fits all. One concept would be to allow each employee take the money currently spent on his plan and, with the same tax benefits the corporation enjoys, purchase his own plan. Details as to exactly how that would be done would need to be worked out; for under current plans younger workers, effectively, subsidize older ones, as do healthy and fit workers subsidize the less healthy and fit. However, broad-based plans with increased competition should allay any fears. It is worth keeping in mind that it is for catastrophic events that we really require insurance. The personal paying of routine doctor visits and generic drugs would result in a smarter, more efficient consumer and a more customer-friendly provider. We would be incentivized to shop for the best doctor (and medicine or service) at the best price. Self interest, knowing that we bear the costs, would encourage people to live ,more active and healthier lives.

Fourth, consumers should be allowed to buy imported drugs. If Canadian companies can sell the same drug for less than their American counterpart, why should American consumers be denied the savings?

Fifth, the number of doctors, nurses and other medical workers should not be kept artificially low. Medical schools should be encouraged to increases student bodies without sacrificing quality. Students from foreign countries once properly vetted,. should be granted the right to become a citizen.

We know there are a number of uninsured. Some of these are the young who see themselves as invincible and so feel no need for insurance. There are illegal immigrants, a group, as we have no sure ways of knowing who they all are, who will likely remain uninsured. There are others who have been laid off and no longer eligible for benefits, but are without means to purchase insurance. And there are the destitute that for whatever reason do not qualify for medicaid. There is not much that we can do for the first group, though their entry into the healthcare system would lower costs for the rest of us, but it does not seem to me that we can require someone to purchase something they do not want. The second group is likely to remain below the radar, causing costs for us as their access to healthcare is often through emergency rooms; though the advent of “minute clinics” and the like is a positive step in lowering costs. For the rest, the government should consider an expansion of medicaid.

The United States has a medical industry known for its research and innovation. People from around the world come to these shores to seek attention. Nothing we do should damage the quality of care we provide, n or the doctors, nurses and staff that provides that care. We have a foundation on which we can build, not a structure that should be torn down.